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Master Thesis

Les Hamartomes mammaires : réévaluation radiologique et histologique d’une entité mal connue

Abstract : Aims: breast hamartomas constitute an underrecognized lesion because they lack a distinctive microscopic appearance. Hence the microscopic diagnosis can be "no significant lesion" or "normal breast tissue" leading to repeated biopsies and diagnostic delay. We aim to describe the histological, immunohistochemical and radiological features of breast hamartomas in order to find specific signs to facilitate their diagnosis and to differentiate them from normal breast and fibroepithelial lesions. Methods and results: 47 breast hamartomas were reassessed (histological diagnosis and imaging features). An immunohistochemical study (ER, PR, CD34, HMGA2) was performed. On breast imaging, hamartomas most often presented as probably benign solid masses with circumscribed margins and variable densities. Histologically, breast hamartomas resembled normal breast although their stromal component was predominant, separating randomly scattered epithelial elements, with areas of pure collagenous stroma. Pseudo angiomatous stromal hyperplasia (PASH) was present in 93.6% of the cases and CD34 antibody highlighted intralobular, perilobular and interlobular distribution of CD34- positive fibroblasts. By comparison, CD34 was mostly expressed in the intralobular and perilobular normal breast tissue stroma. Hamartoma stromal cells expressed HMGA2, ER and PR in 79%, 66% and 76.3% of our cases, respectively. Whereas in normal breast tissue, HMGA2, ER and PR were expressed in 7.7%, 23% and 19% of cases, respectively (p<0.0001; p=0.0005; p<0.0001). Conclusions: after ascertaining that the core needle biopsy was effectively intralesional, breast hamartomas can be diagnosed with confidence when taking into account the presence of stromal changes, PASH, interlobular distribution of CD34-positive fibroblasts, HMGA2 and hormonal receptor stromal expression.
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Submitted on : Monday, August 23, 2021 - 10:49:52 AM
Last modification on : Saturday, August 28, 2021 - 3:12:31 AM
Long-term archiving on: : Wednesday, November 24, 2021 - 6:16:48 PM


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  • HAL Id : dumas-03323961, version 1



Léonie Alran. Les Hamartomes mammaires : réévaluation radiologique et histologique d’une entité mal connue. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03323961⟩



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